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The value of hysteroscopy for abnormal uterine bleeding in menopausal women
Abstracts
Histopathologic examination confirmed the diagnosis. On follow-up, bleeding had ceased in all 19 women. No further therapy was necessary. Conclusion. Hysteroscopic myomectomy can be performed safely and effectively in postmenopausal women.
140. Hysteroscopic Diagnosis and Treatment of Endometrial Polyps JL Mufioz, JS Jimenez, G Vaquero, M Ramirez, C Perez, R Noguero, I Solis, I Martin, C Delgado, C Hernandez, P Miranda, JM Hernandez, P de la Fuente. Hysteroscopy Unit, Hospital 12 Octubre, Madrid, Spain.
Objective. To assess the efficacy of a protocol to diagnose and treat endometrial polyps. Measurements and Main Results. In 2625 hysteroscopies, we found 551 endometrial polyps (20.9%). Of these, 61.4% were in asymptomatic menopausal women. During diagnostic hysteroscopy in women of childbearing age, we found polyps in only 14%. In 35.7% they were 1 to 2 cm and in 21.4% they were larger than 2 cm. Hysteroscopic removal of polyps with the resectoscope was performed in 39.3%. In all polyps smaller than 1 cm we performed biopsy and/or hysteroscopy at 3 months, with resolution of symptoms. No operative complications occurred. Histologic study showed endometrial polyps in 83.2%, endometrial hyperplasia in 6.8%, and endometrial adenocarcinoma in one patient. At follow-up, 96.2 % of women were asymptomatic and hysteroscopy was normal. Conclusion. Hysteroscopy is an effective method of diagnosing endometrial polyps. We recommend hysteroscopic removal of all endometrial polyps, because the procedure is simple, enables complete removal, and provides an accurate diagnosis in a case of malignancy.
Measurements andMain Results'. We conducted a retrospective analysis of 1890 hysteroscopies performed in postmenopausal women. The main symptom (58%) in 1111 patients was AUB. In these patients, 20.4% had endometrial atrophy, 13.9% had endometrial hyperplasia, and 34.3% had an organic lesion (endometrial polyps 21%, uterine myomas 13.3%). Endometrial adenocarcinoma was present in 7.5%. Most commonly, more than one pathology was found, mainly atrophic areas mixed with areas with other pathologies. Treatment in 20.4% of patients was expectant. In 48.2% we performed hysteroscopic resection of pathology and endometrial ablation. The rest of the women underwent hysterectomy. Conclusion. Hysteroscopy is a precise method of diagnosing, treating, and following postmenopausal women with AUB. 142. Ovarian Remnant Syndrome after
Laparoscopic Oophorectomy 1,3CH Nezhat, 1 SFR Nezhat, 1,3CRNezhat, 3SA Mirmalek, 4DS Seidman. 1Stanford University School of Medicine, Stanford, California; 2Mount Sinai Medical Center, New York, New York; 3Center for Special Pelvic Surgery and Northside Hospital, Atlanta, Georgia; 4Sheba Medical Center, Israel.
Objective. To review preoperative histories, clinical characteristics, and surgical techniques in patients with ovation remnant syndrome after laparoscopic oophorectomy. Measurements and Main Results'. Fifteen women (average age 40 yrs, range 25-48 yrs) with ovarian remnant syndrome after multipuncture laparoscopic oophorectomy were evaluated for surgical history. The infundibutopelvic ligament was secured with bipolar desiccation in eight patients, pretied surgical loops in four, linear stapler in two, and two 0 polyglactin sutures in one. In all but one patient, prior oophorectomy was performed for pelvic endometriosis. The other had severe postoperative adhesions. Cystic ovarian remnants were identified by pelvic US in nine women and by CT scan in one. In one patient CT scan and pelvic US identified an abdominal mass. Benign ovarian cysts or tissue was present in all women. Pain was completely resolved in 11 women and partially in 4.
141. The Value of Hysteroscopy for Abnormal Uterine Bleeding in Menopausal Women JL Mufioz, JS Jimenez, C Perez, M Ramirez, G Vaquero, I Martin, C Hernandez, I Solis, R Noguero, P Miranda, JM Hernandez, P de la Fuente. Hysteroscopy Unit, Hospital 12 Octubre, Madrid, Spain.
Objective. To evaluate hysteroscopy for AUB in postmenopausal women.
$40
Histopathologic examination confirmed the diagnosis. On follow-up, bleeding had ceased in all 19 women. No further therapy was necessary. Conclusion. Hysteroscopic myomectomy can be performed safely and effectively in postmenopausal women.
140. Hysteroscopic Diagnosis and Treatment of Endometrial Polyps JL Mufioz, JS Jimenez, G Vaquero, M Ramirez, C Perez, R Noguero, I Solis, I Martin, C Delgado, C Hernandez, P Miranda, JM Hernandez, P de la Fuente. Hysteroscopy Unit, Hospital 12 Octubre, Madrid, Spain.
Objective. To assess the efficacy of a protocol to diagnose and treat endometrial polyps. Measurements and Main Results. In 2625 hysteroscopies, we found 551 endometrial polyps (20.9%). Of these, 61.4% were in asymptomatic menopausal women. During diagnostic hysteroscopy in women of childbearing age, we found polyps in only 14%. In 35.7% they were 1 to 2 cm and in 21.4% they were larger than 2 cm. Hysteroscopic removal of polyps with the resectoscope was performed in 39.3%. In all polyps smaller than 1 cm we performed biopsy and/or hysteroscopy at 3 months, with resolution of symptoms. No operative complications occurred. Histologic study showed endometrial polyps in 83.2%, endometrial hyperplasia in 6.8%, and endometrial adenocarcinoma in one patient. At follow-up, 96.2 % of women were asymptomatic and hysteroscopy was normal. Conclusion. Hysteroscopy is an effective method of diagnosing endometrial polyps. We recommend hysteroscopic removal of all endometrial polyps, because the procedure is simple, enables complete removal, and provides an accurate diagnosis in a case of malignancy.
Measurements andMain Results'. We conducted a retrospective analysis of 1890 hysteroscopies performed in postmenopausal women. The main symptom (58%) in 1111 patients was AUB. In these patients, 20.4% had endometrial atrophy, 13.9% had endometrial hyperplasia, and 34.3% had an organic lesion (endometrial polyps 21%, uterine myomas 13.3%). Endometrial adenocarcinoma was present in 7.5%. Most commonly, more than one pathology was found, mainly atrophic areas mixed with areas with other pathologies. Treatment in 20.4% of patients was expectant. In 48.2% we performed hysteroscopic resection of pathology and endometrial ablation. The rest of the women underwent hysterectomy. Conclusion. Hysteroscopy is a precise method of diagnosing, treating, and following postmenopausal women with AUB. 142. Ovarian Remnant Syndrome after
Laparoscopic Oophorectomy 1,3CH Nezhat, 1 SFR Nezhat, 1,3CRNezhat, 3SA Mirmalek, 4DS Seidman. 1Stanford University School of Medicine, Stanford, California; 2Mount Sinai Medical Center, New York, New York; 3Center for Special Pelvic Surgery and Northside Hospital, Atlanta, Georgia; 4Sheba Medical Center, Israel.
Objective. To review preoperative histories, clinical characteristics, and surgical techniques in patients with ovation remnant syndrome after laparoscopic oophorectomy. Measurements and Main Results'. Fifteen women (average age 40 yrs, range 25-48 yrs) with ovarian remnant syndrome after multipuncture laparoscopic oophorectomy were evaluated for surgical history. The infundibutopelvic ligament was secured with bipolar desiccation in eight patients, pretied surgical loops in four, linear stapler in two, and two 0 polyglactin sutures in one. In all but one patient, prior oophorectomy was performed for pelvic endometriosis. The other had severe postoperative adhesions. Cystic ovarian remnants were identified by pelvic US in nine women and by CT scan in one. In one patient CT scan and pelvic US identified an abdominal mass. Benign ovarian cysts or tissue was present in all women. Pain was completely resolved in 11 women and partially in 4.
141. The Value of Hysteroscopy for Abnormal Uterine Bleeding in Menopausal Women JL Mufioz, JS Jimenez, C Perez, M Ramirez, G Vaquero, I Martin, C Hernandez, I Solis, R Noguero, P Miranda, JM Hernandez, P de la Fuente. Hysteroscopy Unit, Hospital 12 Octubre, Madrid, Spain.
Objective. To evaluate hysteroscopy for AUB in postmenopausal women.
$40